Is there a basic treatment algorithm to control children’s pain?
There are substantial disparities in pain treatment with undertreatment and inadequate treatment common in children. One significant contributing factor to undertreatment is lack of US Food and Drug Administration (FDA) approval and guidance for prescribing pain medications to children. Another factor is the lack of robust evidence for the effectiveness of nonpharmacologic treatments for children’s pain. In spite of these contributing factors, the basic treatment algorithm to control children’s pain is similar to that of treating any individual with pain. Begin with a thorough assessment. Evaluate the primary sensory characteristics of pain, including pain location, intensity, duration, timing, pattern, quality, and aggravating and alleviating components. Also assess the extent to which cognitive, behavioral, and emotional factors may influence the pain experience. Obtain a thorough medical history, pain history, and physical examination. Complete any necessary diagnostic tests. Then develop a differential diagnosis and a multimodal treatment plan (include analgesics, cognitive, physical, and behavioral interventions) to address all dimensions of the pain experience. Partner with children and parents to promote adherence to treatment plans by first explaining and addressing potential causes of the pain and any contributing factors. Finally, regularly evaluate treatment plan effectiveness, and revise the plan as needed.